Pharmacy Benefit Configuration Analyst
Posted on 11/30/2023
INACTIVE
Abarca Health

501-1,000 employees

Personalized healthcare technology solutions
Company Overview
Abarca is on a mission to revolutionize healthcare. The company believes that with smarter technology pharmacy benefits can be redefined. Through a combination of aggressive pharmacy network design, the right formulary and clinical programs, rebates, and competitive admin fees, Abaraca helps payers minimize costs while maximizing the health and healthcare experience for members.
Financial Services
Data & Analytics

Company Stage

N/A

Total Funding

N/A

Founded

2005

Headquarters

San Juan, Puerto Rico

Growth & Insights
Headcount

6 month growth

9%

1 year growth

11%

2 year growth

31%
Locations
Remote in USA
Experience Level
Entry
Junior
Mid
Senior
Expert
Desired Skills
Communications
SQL
CategoriesNew
Medical, Clinical & Veterinary
Requirements
  • Associate or bachelor’s degree
  • 3+ years of work-related experience
  • Experience working with SQL and Excel tools
  • Good interpersonal skills
  • Excellent oral and written communication skills
Responsibilities
  • Pharmacy Benefit Manager System Configuration setup and maintenance for pharmacy benefits, networks and pricing for Medicare, Medicaid, Commercial and Employer groups
  • Perform testing to confirm configuration set-up or changes are processing as expected as defined in the client documentation
  • Develop in-depth understanding of Darwin (proprietary adjudication platform) system logics to ensure benefit designs are configured to meet client request
  • Provide timely first-tier triage support to verify and analyze pharmacy claims processing case research referred for validation
  • Support pharmacy claims adjudication research, analysis, identification of root cause, impact analysis determination and corrective action
  • Responsible for daily tracking and monitoring of assigned requests to ensure due dates are met
  • Utilize critical thinking and organizational skills to ensure all work is performed with the highest level of quality, accuracy and delivered timely
Desired Qualifications
  • Experience in a healthcare non-retail pharmacy setting
  • Experience related to Pharmacy Benefit Manager Operations, Member Services, Pharmacy Networks, Fulfillment, Call Center, and Medicare